Patient guide · Respiratory medicine
Lung health & lung cancer assessment, bundled respiratory workup with low-dose CT, spirometry and consultant review.
A bundled same-day lung health assessment: low-dose CT for lung cancer screening, spirometry with reversibility, gas transfer, blood tests and consultant respiratory review — with a personalised risk-reduction plan.
Reviewed by Pulse Atlas Editorial Board () · Last reviewed 2026-07-30 · Next review 2027-07-30 · 6 min read
Why it matters
- 01
A bundled respiratory workup
Low-dose CT, spirometry, gas transfer, blood tests and a consultant respiratory review — done as a single, coordinated day.
- 02
Aligned to NHS best practice
Modelled on the NHS Targeted Lung Health Check, but delivered privately in one visit rather than across weeks.
- 03
A plan, not just a scan
You leave with a personalised risk-reduction plan — cessation, rehab, inhaled therapy or MDT referral where indicated.
Key facts
The lung health assessment in six lines.
A quick, plain-English summary of what the bundle includes, the radiation dose and the onward pathway.
| Fact | Detail |
|---|---|
| Definition | A bundled respiratory workup combining low-dose CT, spirometry, gas transfer, blood tests and consultant respiratory review. |
| The pathway | Same-day: consultation, LDCT, lung function tests, bloods and results discussion in one visit. |
| LDCT radiation dose | Approximately 1.5 mSv — comparable to about six months of natural background radiation. |
| Clinical alignment | Aligned to the NHS Targeted Lung Health Check and NICE lung cancer guidance (NG122). |
| Lifestyle output | Personalised smoking cessation support and pulmonary rehabilitation referral where indicated. |
| Onward pathway | Multi-disciplinary team-linked — direct routes to lung cancer MDT, respiratory or thoracic surgery. |
The pathway
What happens, step by step.
From eligibility through to a written plan — the whole assessment fits into a single visit.
Phase 1 · Before
Eligibility and consent
Phase 2 · On the day
LDCT, lung function and bloods
Phase 3 · After
Structured, personalised plan
- 01
Before
Eligibility assessment
A short questionnaire confirms age, smoking history and risk factors — and whether a bundled lung health assessment is the right test for you.
- 02
Before
Consultation and consent
A consultant respiratory physician takes a full history, explains the pathway and confirms consent for imaging and lung function testing.
- 03
On the day
Low-dose CT of the chest
A low-dose CT (~1.5 mSv) of the chest is performed in a single breath-hold to look for nodules, emphysema and interstitial change.
- 04
On the day
Spirometry with reversibility
Standard spirometry, repeated after a bronchodilator, characterises airflow obstruction and reversibility — the COPD versus asthma question.
- 05
On the day
Gas transfer (TLCO)
Transfer factor for carbon monoxide measures how efficiently gas crosses the alveolar membrane — a sensitive early marker of emphysema and ILD.
- 06
On the day
Blood tests
Full blood count, renal and liver function, HbA1c and cardiovascular markers as a shared baseline for risk-factor optimisation.
- 07
After
Structured plan
A written, personalised plan: risk category, cessation and rehab actions, any surveillance interval and onward referrals — all in one document.
What it shows
What a bundled lung health assessment can pick up.
The pathway is designed around lung cancer detection, but the LDCT and lung function tests reveal a rounded picture of respiratory and cardiovascular risk.
-
Lung nodule detection
Small pulmonary nodules — the primary target of the LDCT screen, characterised for size, density and morphology.
-
Emphysema quantification
Low-attenuation lung and destruction of alveolar architecture, quantified against normal-density lung.
-
Interstitial lung disease
Reticulation, honeycombing and ground-glass change suggestive of fibrotic or inflammatory interstitial disease.
-
Coronary calcium (incidental)
Coronary artery calcification is quantified as an incidental cardiovascular risk marker on the same CT.
-
Aortic aneurysm (incidental)
Thoracic aortic diameter is measured — an important incidental finding on chest CT.
-
Spirometry pattern
FEV1, FVC and the FEV1/FVC ratio — obstructive, restrictive or mixed patterns with reversibility.
-
TLCO baseline
A baseline transfer factor for future comparison — the earliest quantitative signal of alveolar-capillary disease.
-
Red flag: >8mm spiculated nodule — 2WW pathway
A spiculated nodule greater than 8mm triggers the two-week-wait suspected lung cancer pathway with urgent MDT referral.
Next steps
What happens after your assessment.
The onward pathway depends on findings — from reassurance and cessation support through to surveillance imaging or direct MDT referral.
-
Reassurance for a negative screen
A clean LDCT and normal lung function is highly reassuring — with a documented interval before any repeat screen is considered.
-
Fleischner nodule surveillance
Sub-threshold nodules are followed with the Fleischner Society interval CT protocol — size, density and risk-adjusted.
-
Smoking cessation
Structured cessation support with pharmacotherapy (varenicline, NRT), behavioural counselling and follow-up review.
-
Pulmonary rehabilitation
A supervised exercise and education programme — the highest-impact non-drug intervention for symptomatic COPD.
-
Inhaled therapy for COPD
Stepwise inhaled therapy — LAMA, LABA and, where indicated, ICS — with inhaler technique review and follow-up spirometry.
-
Referral to lung cancer MDT
Suspicious findings are routed directly to a thoracic multi-disciplinary team for staging, biopsy planning and treatment.
-
Cardiovascular risk optimisation
Blood pressure, lipid and glycaemic control alongside lung optimisation — cardiovascular disease is the leading competing risk.
-
Structured follow-up
A defined follow-up interval — for surveillance, cessation review or rehab outcomes — booked before you leave.
Red flags
When lung findings need urgent action.
These are the imaging, functional and clinical patterns that trigger a two-week-wait pathway, MDT referral or specialist escalation rather than routine follow-up.
-
Spiculated lung mass
A spiculated lesion, particularly in an upper lobe, is highly suspicious for primary lung malignancy and warrants urgent MDT referral.
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Nodule growth
Interval growth of a previously stable nodule is a red flag — the Fleischner interval protocol is superseded by a suspected-cancer pathway.
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Severe airflow obstruction
FEV1 below 50% predicted with clinical symptoms indicates severe COPD — inhaled therapy escalation and pulmonary rehab referral.
-
Rapid TLCO decline
A significant fall in transfer factor over months suggests progressive emphysema, interstitial disease or pulmonary vascular disease.
-
Suspected mesothelioma
Pleural thickening, pleural effusion or a pleural mass — particularly with asbestos exposure — is a two-week-wait indication.
-
Occupational lung disease
Asbestos, silica or coal-related change on imaging requires occupational history, industrial disease reporting and specialist review.
-
Alpha-1 antitrypsin deficiency
Basal-predominant emphysema, especially in a younger patient, prompts alpha-1 antitrypsin testing and genetic counselling.
-
Interstitial pneumonia with hypoxia
Interstitial change with resting or exertional hypoxia requires urgent ILD-MDT review and consideration of anti-fibrotic therapy.
-
Post-COVID lung disease
Persistent post-COVID interstitial change or reduced gas transfer warrants dedicated post-COVID lung follow-up.
Reading your report
A lung health assessment report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Indication and risk factors
Your details, smoking history, occupational exposures and comorbidities that shape LDCT and lung function interpretation.
- 02 Technique
LDCT protocol and lung function method
Low-dose CT parameters, spirometry reversibility protocol and gas transfer methodology used on the day.
- 03 Findings
Nodules, parenchyma and function
Nodule characterisation, emphysema and ILD signs, incidental cardiovascular findings, and quantitative spirometry and TLCO values.
- 04 Impression
The conclusion: read this first
Overall risk category, any 2WW or MDT triggers, and the concrete next step — surveillance, cessation, rehab or referral.
Frequently asked
Everything patients ask about the lung health assessment.
Quick answers on who it is for, radiation dose, how it compares with the NHS Targeted Lung Health Check, and what happens if a nodule is found.
-
What is a lung health and lung cancer assessment?
It is a bundled, same-day respiratory workup that combines a low-dose CT of the chest for lung cancer screening, spirometry with reversibility, gas transfer (TLCO), blood tests and a consultant respiratory review — with a written, personalised risk-reduction plan.
-
Who is it for?
It is designed for adults with a smoking history, occupational exposure to lung carcinogens, a strong family history of lung cancer, or unexplained respiratory symptoms who want a rounded assessment beyond a single scan or single test.
-
How much radiation is involved?
The low-dose CT delivers approximately 1.5 mSv — comparable to about six months of natural background radiation, and substantially less than a standard diagnostic chest CT.
-
How does it compare with the NHS Targeted Lung Health Check?
The pathway is modelled on the NHS Targeted Lung Health Check for eligible 55–74 year-olds with a smoking history, but delivered privately in a single day and available regardless of NHS eligibility.
-
What happens if a nodule is found?
Small nodules are followed with the Fleischner Society interval CT protocol. A larger, growing or spiculated nodule triggers the two-week-wait suspected lung cancer pathway with direct MDT referral.
-
When is it not the right test?
Acute severe breathlessness, haemoptysis or suspected acute infection needs urgent assessment — call 999 or attend A&E rather than book a screening pathway.
Sources
Where this guide comes from.
- NHS. Targeted Lung Health Check Programme.
- NICE. Lung cancer: diagnosis and management (NG122).
- British Thoracic Society. COPD guidance and quality standards.
- ERS/ATS. Standardisation of lung function testing.
Reviewed by Pulse Atlas Editorial Board (). Last reviewed 2026-07-30. Next review 2027-07-30.
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In practice, in London
What lung health and lung cancer assessment looks like on the ground in London
With lung health and lung cancer assessment, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Public provision for lung health and lung cancer assessment is competent but constrained by capacity. Private London clinics tend to have shorter diaries and longer appointment slots, so you get the same specialists with more time. For people who’ve been going round in circles with primary care, that first proper conversation is often what shifts things.
The mechanics are straightforward: a consultant appointment, any tests done at a nearby CQC-registered site, and a written report back within a few days. London’s density of private diagnostics — Marylebone, the City, Chelsea, Canary Wharf — means most patients can find something that fits around work without a cross-town trek. For lung health and lung cancer assessment specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
We’re careful about what a private pathway for lung health and lung cancer assessment can and can’t promise. It can compress a wait, put you in front of a subspecialist quickly, and get a proper report in your hands within a week. It can’t rewrite what the imaging or the bloods say. Setting that expectation up front tends to make the whole experience less stressful.